Children and young people can have a wide range of life limiting conditions and may sometimes live with such conditions for many years. This guideline recommends that end of life care be managed as a long term process that begins at the time of diagnosis of a life limiting condition and entails planning for the future. Sometimes it may begin before the child’s birth. It is part of the overall care of the child or young person and runs in parallel with other active treatments for the underlying condition itself. Finally, it includes those aspects related to the care of the dying.

Children admitted to hospital with severe asthma attacks generally receive “very effective and efficient” treatment and care, but more attention must be given to asthma education and review at discharge to help prevent future attacks and readmission, says a national audit by the British Thoracic Society.

The society’s National Paediatric Asthma Audit, published on 29 November, reviewed data on more than 5500 children over the age of 1 admitted with severe asthma attacks to 153 UK hospitals in November 2015 and found that most aspects of discharge from hospital were less than optimal.

Scientists at Edinburgh University have developed a service to store testicular tissue from boys as young as 1 who are at risk of infertility because of cancer treatment. In future boys as well as girls might be able to have their fertility restored subsequent to chemotherapy.

The announcement comes after the birth of the first UK baby to be born after his mother had a transplant of her own, previously frozen, ovary tissue.

Children with disabilities who have an initial unsubstantiated referral for neglect are at increased risk of being maltreated subsequently, a research letter published in JAMA has warned.

Researchers analysed data from the National Child Abuse and Neglect Data System, which collects data on children reported to child protection services in the United States and Puerto Rico. A total of 12 610 children with disabilities and 476 566 without disabilities who had first time unsubstantiated referrals for neglect in 2008 were included in the study and followed up for four years.

Children who reduce their consumption of sugar sweetened drinks by just one serving a week see improvements in their high density lipoprotein (HDL) cholesterol levels, a study published in the Journal of Nutrition has found.

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The US study used data from a multiethnic sample of 613 children aged 8 to 15 who were enrolled in a randomised double blind vitamin D supplementation trial. They self reported their intake of sugar sweetened beverages and had their fasting blood lipid concentrations measured at baseline.

Two thirds of the children were from low socioeconomic status households, almost half were overweight or obese, and 59% were from non-white or Caucasian ethnic groups. The researchers followed 380 of the children for 12 months.

Banning smoking in public places has cut hospital admissions for childhood respiratory infections in England by 11 000 a year, new research has estimated.

Researchers from the United Kingdom and the Netherlands said that evidence has shown that smoke-free public environments will benefit children’s health but that the exact effect on respiratory tract infections is unclear.

More children survived for at least 30 days after heart surgery at the end of the past decade than at the start, an analysis has found. The death rate fell from 4.3% to 2.6% of cases.

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The findings have prompted the researchers to call for a shift away from scrutinising short term survival to looking at the longer term effects of heart surgery in children, such as measures of ill health and the effect on functional capacity.

BMJ Learning are looking at how vitamin D deficiency presents in children. Do you know what investigations to carry out when you suspect it? And lastly do you know how to manage vitamin D deficiency once it is diagnosed?

You see a 28 year old tennis player who has pain in his right knee. This started during a match four days ago. He twisted to hit a ball but his foot remained in the same position. What is most likely to be going on? And what tests would you do? If you are not sure then this module will help. Click on the link to complete it today:

Extract from newsletter

Each of these one-page summaries reports on the innovative ways in which nurse-led teams across the UK have been supported by FoNS to work with patients, relatives and staff in their drive to deliver excellent care.

FoNS is committed to supporting the development of nursing and healthcare practice and one of the ways we achieve this is by providing freely accessible information. All the projects and initiatives reported on have been supported by one of FoNS’ practice based development and research programmes and have aimed to:

Respond to the needs of patients

Improve patients’ experience of care

Be evidence based (including practice knowledge and service users’ experience)

Analysis of data from a large randomised controlled trial suggests that intensive glucose control in critically ill patients is associated with moderate to severe hypoglycaemia, and a higher risk of death.

A cross-sectional study investigating a possible link between harsh physical punishment and mental health disorders reports that reducing physical punishment may help to reduce the prevalence of mental health disorders in the general population. It suggests giving parents information about alternative discipline strategies, such as positive reinforcement.

The QIPP Collection highlights examples of local best practice, demonstrating how NHS organisations have implemented new practices that have both cut costs and improved quality. We highlight a new example:

This pledge aims to make improvements to the health of children and young people and is part of the government’s response to the Children and Young People’s Health Outcomes Forum.
It commits signatories to put children, young people and families right at the heart of decision making and improve every aspect of health services – from pregnancy through to adolescence and beyond.

The King’s FundThis quality standard on the diagnosis and treatment of asthma in adults, young people and children aged 12 months and older argues that an integrated approach to services is vital. The new quality standard on asthma consists of a prioritised set of specific, concise and measurable statements that, when delivered collectively, should contribute to improving the effectiveness, quality, safety and experience of care for people with the condition.

Abdominal conditions in children are common and have a wide range of causes. In this latest module Dr Ian Wacogne outlines the common causes of various abdominal problems in children and how to recognise and manage them.

Background Establishing the diagnosis in a child presenting with an atraumatic limp can be challenging. There is particular difficulty distinguishing septic arthritis (SA) from transient synovitis (TS) and consequently clinical prediction algorithms have been devised to differentiate the conditions using the presence of fever, raised erythrocyte sedimentation rate (ESR), raised white cell count (WCC) and inability to weight bear. Within Europe measurement of the ESR has largely been replaced with assessment of C-reactive protein (CRP) as an acute phase protein. We have evaluated the utility of including CRP in a clinical prediction algorithm to distinguish TS from SA.

Method All children with a presentation of ‘atraumatic limp’ and a proven effusion on hip ultrasound between 2004 and 2009 were included. Patient demographics, details of the clinical presentation and laboratory investigations were documented to identify a response to each of four variables (Weight bearing status, WCC >12,000 cells/m3, CRP >20mg/L and Temperature >38.5 degrees C. The definition of SA was based upon microscopy and culture of the joint fluid collected at arthrotomy.

Results 311 hips were included within the study. Of these 282 were considered to have transient synovitis. 29 patients met criteria to be classified as SA based upon laboratory assessment of the synovial fluid. The introduction of CRP eliminated the need for a four variable model as the use of two variables (CRP and weight bearing status) had similar efficacy. An algorithm that indicated a diagnosis of SA in individuals who could not weight-bear and who had a CRP >20mg/L correctly classified SA in 94.8% individuals, with a sensitivity of 75.9%, specificity of 96.8%, positive predictive value of 71.0%, and negative predictive value of 97.5%. CRP was a significant independent predictor of septic arthritis.

CASH aims to keep health professionals up-to-date with new developments for the benefit of patient care and improved decision making. It is a collaborative service provided by librarians from around England who monitor and capture content from across 3 broad sectors – Primary Care, Secondary Care and Mental Health.

NHS Evidence provides access to more than 300,000 reliable resources from 1,300 sources. The number of evidence providers we receive information from is increasing every month.

Fact sheets from the Meningitis Trust are a recent addition to the search. The resources are primarily patient support information and cover a range of issues including developmental difficulties following meningitis, recovering after leaving hospital, entitlement to statutory benefits, and coping with bereavement. There are also fact sheets written specifically for child carers, teachers and pupils, employers, colleges and universities, and health professionals.

The Meningitis Trust was one of the first charities to become a certified member of The Information Standard.